Is the Time Right for You to Provide Telepsychiatric Services?

Several recent articles in Psychiatry Advisor addressed the potential benefits of telepsychiatric services: John Fortney, PhD, discussed the clinical benefits of telepsychiatry, Gonzalo J. Perez-Garcia, MD, described how these services can reduce ER boarding times, and John Kane, MD, wrote about teaching telepsychiatry in residency training programs.

Telepsychiatric care appears to be gaining favor as a way of providing patient access to care that would otherwise be unavailable and practitioners are increasingly gaining experience and comfort with this service modality. Thus I wonder, how many psychiatric practitioners are wondering whether telepsychiatric services are right for their practices?

According to the federal government's Medicaid website, telemedicine “seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site.” In other words, telemedicine is real-time person-to-person televideo conferencing. Many of us are communicating with family and friends and conducting other types of business using video conferencing — so why not apply this in our clinical practices?

Behavioral health is “natural fit” for telehealth care since, in most instances, we do not physically examine our patients ourselves. I think one could also make an argument that our patients — many of whom are disproportionally affected by other barriers to care like limited finances and transportation — might most benefit from the convenience of telemedicine.

A number of studies have demonstrated the effectiveness of telebehavioral health in comparison to traditional in-person services in a large number of clinical environments, in different clinical populations, and with different populations.1 Many of these studies have also demonstrated that both patients and providers appreciate the services, and value the increased access to care and/or convenience.

The benefits of telebehavioral health may extend beyond simply providing access to care to patients who are geographically distant from treating providers and specialists. It is increasingly being considered as a solution to providing access to care that is more efficient, more culturally competent, more linguistically appropriate, or just plain more convenient than face-to-face care.

I have been providing telepsychiatric care for a number of years to patients enrolled in an integrated primary care/mental health program in Washington State. Not only is it the part of my clinical schedule that I most look forward to, I'm also surprised how easy it was to get set up as a new practitioner.